Little is known about the precise date of the emergence of decapitation in a ritual context and the presence of systematic postmortem modification patterns in the ancient Central Andes. The ceremonial complex at Pacopampa in the northern Peruvian highlands provides early osteological evidence of decapitation in six individuals dating to the latter half of the Late-Final Formative Periods (500-50 BC) and to the Early Cajamarca Period (AD 200-450). Based on osteological evidence, and when taken together with archaeological settings and settlement patterns, researchers can be certain that those whose heads were disembodied were not likely to have been involved in organized battles. In addition, the similarities in the cut-mark distribution, direction, and cross-sectional morphology of each individual's remains, as well as the characteristics of selected individuals, imply that the decapitated individuals were carefully prepared using a standardized method and that those who modified the heads may have been professional decapitators. This study offers indisputable bioarchaeological evidence of ritualistic offerings of human skulls and systematic postmortem modification patterns, which is consistent with a contemporaneous iconographic motif of decapitation and extends the chronology of this practice back to the Formative Period in the northern Peruvian highlands.